OBJECTIVES: This research estimates incremental cost-utility ratios for atorvastatin, simvastatin and pravastatin for treatment of patients with hypercholesterolemia in secondary prevention and various age groups. METHODS: By using a Markov model with five final outcomes, namely angina pectoris (AP), myocardial infarction (MI), cerebrovascular disease (CVD), absence of cardiovascular events and death, the medical care cost–utility in the treatment of patients with hypercholesterolemia was estimated. The following age groups were identified: 41-50 years, 51-60 years, 61-70 years and 71-80 years. The follow-up period was ten years. A 5% discount rate was used for cost-utility analysis. The perspective was that of the National Health System. Quality-adjusted life-year estimates (QALYs) for each final outcome were obtained through a survey among cardiologists with clinical experience and life extension tables in the literature. Life years adjusted by life quality were constructed. Costs per age group and type of event were obtained by reviewing clinical records. Probabilistic sensitivity analysis was performed and acceptability curves were constructed. RESULTS: Costs and utilities vary among the various age groups. The lowest annual average medical care cost per patient corresponds to patients in the 41-50 year age group (US $33,000), and the highest among patients in the 71-80 year age group (US $101,632). The 41-50 year age group produced 5.8 QALYs being the highest, and the 71-80 year age group produced the lowest – an average of 0.5 QALYs. In all age groups, atorvastatin turned out to be the dominant treatment. CONCLUSIONS: The use of atorvastatin in Mexico is the more cost-utility treatment in patients with hypercholesterolemia in secondary prevention in various age groups, but incremental cost–utility ratios among older patients are actually the highest.